Depression EXSS 3070 Lecture Flashcards

Vocabulary flashcards based on the EXSS 3070 lecture notes on depression.

Mental illnesses

Health conditions involving changes in emotion, thinking or behavior (or a combination of these). Associated with distress and/or problems functioning in social, work or family activities.

Mental illness (DSM-5 Criteria)

A behavioural or psychological syndrome or pattern that occurs in an individual, reflects an underlying psychobiological dysfunction, and the consequences of which are clinically significant distress or disability.

ICD

International Classifications of Diseases; created by the World Health Organization. Comprises 17,000 diagnostic categories and 100,000 medical diagnostic index terms.

DSM-5-TR

Diagnostic and Statistical Manual of Mental Disorders; created by the American Psychiatric Association. Contains a listing of diagnostic criteria for every psychiatric disorder recognized by the U.S. healthcare system.

Mood

A conscious state of mind or predominant emotion; a prevailing attitude.

Affective disorder

A psychological disorder characterised by the elevation or lowering of a person’s mood, interfering with an individual’s daily life.

Major Depressive Disorder (DSM-5-TR)

Five or more symptoms present for most of the day during the same two-week period, representing a change from previous functioning.

Minor Depressive Disorder

Two-to-four symptoms present for most of the day during the same two-week period, representing a change from previous functioning.

Mania (DSM-5)

A distinct period of abnormally and persistently elevated, expansive, or irritable mood, and abnormally and persistently increased goal-directed activity or energy.

Epidemiology of Depression and Bipolar Disorder

12-month prevalence of major depressive disorder is 6%. Lifetime risk is 11-15%. Gender ratio F:M 2:1. Lifetime prevalence of bipolar disorder is 1%. Gender ratio F:M 1:1 Highest suicide risk (30-60 times the general population) in bipolar disorder.

Global Burden of Depression

Leading cause of disability and ill health worldwide. Globally, depressive disorders are the single largest contributor to non-fatal health loss (7.5% of all YLD).

Causes of Depression

External life stressors, drugs and alcohol, internal medical illnesses, past bad experiences, personality patterns of thinking, high anxiety, chemical changes, and family disposition.

Significance of cognitive impairments in Late Life Depression

Tend to persist even if symptoms are treated. Lack of cognitive improvement is associated with increased risk of dementia. Depression with mild cognitive impairment is associated with a twofold risk of developing Alzheimer’s disease.

Depression in older vs. younger individuals

May be less likely to report psychiatric discomfort as depression, sense of emptiness more than negative feelings, pessimism more than low self-esteem.

Diagnoses/Referrals

General Practitioners, Psychologists, Psychiatrists, Neurologists, Other medical professionals

Management/Prevention

Medical practitioners/specialists, Allied health practitioners, Psychologists, Behaviourial therapists, Counselors, Social workers, Art therapists, Exercise Physiologists

RANZCP Guidelines

The 2020 Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for mood disorders.

Pharmacotherapy

SSRIs, SNRIs, TCAs, MAOIs - Choices depend on Symptoms and Side Effects

Head to Health

A government website to assist consumers identify digital resources and programs for a range of problems including depression.

MindSpot

Online clinic, offering free evidence-based iCBT programs with therapist assistance for a range of problems including depression.

Physical Activity Guidelines Advisory Committee (2018)

Strong evidence demonstrates that moderate-to-vigorous physical activity reduces the risk of developing major depression. It also reduces the symptoms of depression among individuals with and without clinical levels of depression.

Low dose aerobic exercise (NOT EFFECTIVE)

7 kcal/kg/week (3 or 5 days per week)

Public Health Dose aerobic exercise (EFFECTIVE)

17.5 kcal/kg/week (3 or 5 days per week)

High Intensity PRT

Reduces depression significantly more than Low Intensity PRT or referral to GP for Usual Care.

Proposed Mechanisms of Exercise Benefit in Depressive Illness

Mastery, self-efficacy, Internal locus of control, Self-esteem, Sense of purpose, eudaimonic happiness, Reduction in catabolic/inflammatory profile (cortisol, cytokines), Increase in anabolic/neurotrophic factors (BDNF, IGF-1, serotonin, others).

ESSA

Consensus statement related to exercise for mental health.

Exercise Tips in Depressive Illness

Exercise improves sleep and mood in people with mood disorders and improves general health.

Practical Issues in Implementation of Exercise for MH Disorders

Be aware of new suicidal ideation, increased symptom severity or substance use, withdrawal symptoms, side effects of anxiolytics and anti- depressants, co-morbid physical illnesses.

Other Practical Issues in Implementation of Exercise for MH Disorders

Monitor ALL psychological and medical co- morbidities. Alcohol AUDIT-C questionnaire, PSQI for insomnia, PHD-9 or GDS for depression, PTSD checklist, GAD-7 for anxiety.